A migraine headache is a specific kind of headache that can last for hours to days. It can cause intense pain as well as other symptoms. For example, you may feel sick to your stomach or have changes in your vision just before or during the headache.
The exact cause of migraines is not clear. Most experts think migraine attacks start with abnormal activity in the brain. They may be related to a problem with the blood flow in your brain, or they may happen with changes in brain chemicals. Migraine headaches often are triggered by specific things. Common migraine triggers include:
Migraines tend to run in families. They affect women 3 times more often than men. They often happen right before or during a woman's menstrual period. Or they may happen when a woman is taking birth control pills or hormone replacement pills.
Before a migraine starts, there is often a warning period when you don't feel well. Some people have vision changes before their head starts hurting. They lose part of their vision or see bright spots or zigzag patterns. These warning symptoms are called migraine aura. The vision changes of the aura usually go away as the headache begins.
Migraine symptoms may include:
The pain is usually more severe on one side of the head, but it can affect the whole head.
Sometimes a migraine can cause symptoms such as numbness or even weakness. However, these can also be symptoms of a stroke. If you have these other symptoms along with problems with your vision, do not assume a migraine is the cause. Call your healthcare provider right away.
Your healthcare provider will ask about your symptoms and medical history and examine you. There are no lab tests or X-rays for diagnosing migraine headaches.
A careful history of your headaches is very helpful. Your healthcare provider may ask you to keep a headache diary in which you record the following:
Depending on your headache symptoms and physical exam, your provider may recommend tests to check for other, more serious causes of your symptoms. For example, you may have a brain scan or magnetic resonance imaging (MRI).
You may be able to stop mild migraine headaches by taking nonprescription pain-relief medicine when you start to have symptoms. Aspirin, acetaminophen, caffeine, ibuprofen, and naproxen have all been shown to be effective. You may find that any one of these medicines alone will treat your headache. Even just a caffeinated drink may help. However, some studies have shown combinations to be more effective and to work faster. Excedrin Migraine is an example of such a combination. It includes acetaminophen, aspirin, and caffeine. Other combination drugs, such as Midrin, are available for mild to moderate headaches with a prescription from your healthcare provider.
Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Aspirin, ibuprofen, and naproxen are nonsteroidal anti-inflammatory medicines (NSAIDs). NSAIDs may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take NSAIDs for more than 10 days for any reason.
Other medicines your healthcare provider may prescribe to help keep headaches from getting severe once they start are:
It's best to take these medicines as soon as possible after a headache begins. This means you need to recognize the warning symptoms.
If you have frequent migraines (3 or more a month), you may need to take other medicine every day to prevent severe and frequent headaches. Examples of drugs your provider may prescribe for this purpose are:
Women who have migraines triggered by their menstrual cycle may take preventive medicines for a few days around their period. Medicines that may be recommended are NSAIDs, triptans, and ergots. If these medicines do not work, hormone (estrogen) therapy may be helpful. Hormone therapy may also be helpful for women who have migraines during or after menopause. However, there is an increased risk of stroke for women with migraines who use birth control products (contraceptives) that contain estrogen.
You may need to take preventive medicine for several weeks before you know if it is helpful for you.
If you are planning to get pregnant, be sure to talk to your healthcare provider about whether the medicines you have been prescribed are safe during pregnancy. If they are not known to be safe, you will need a different treatment plan while you are trying to get pregnant and during pregnancy and breast-feeding.
The headache may last from a few hours to a few days. You may tend to get migraines for the rest of your life. However, many people find that they have migraines less often as they get older.
When you have a migraine:
You can make your migraines easier to take care of. Learn to become aware of your early warning signs of headache. You will need to pay close attention to your body to be aware of these signs. When the warning signs appear, try going to a quieter place and doing relaxation exercises. This early care can make a big difference in how easily you can get over the migraine.
If your symptoms don't get better when you take medicine, make another appointment with your healthcare provider. It may take several visits to find the best way to control your headaches. Also, if you are having headaches more often, make a follow-up appointment with your provider to see if something has changed or you need more testing or preventive medicine.
Call your healthcare provider right away if:
Prevention is an important part of treatment. To help prevent migraine headaches:
For more information, call or write:
American Council for Headache Education (ACHE)
Phone: 800-255-ACHE (255-2243)
Web site: http://www.achenet.org
National Headache Foundation
Web site: http://www.headaches.org
(includes more information about diet)